In other news: Hematologic cancer focus
medwireNews: This month we round-up four hematologic cancer trials, two looking at treatment options for older and younger patients with Hodgkin lymphoma (HL), and two evaluating treatments for smoldering and relapsed or refractory multiple myeloma (MM). Read on to find out more.
Sequential brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (AVD) leads to “robust outcomes” in patients aged 60 years or older with a new diagnosis of HL, a “historically difficult-to-treat patient population,” report Andrew Evens (Rutgers Cancer Institute of New Jersey, New Brunswick, USA) and team in the Journal of Clinical Oncology.
Of the 42 response-evaluable patients in the phase II trial, 95% achieved an overall response and 90% had complete remission after treatment with two lead-in cycles of brentuximab vedotin 1.8 mg/kg every 3 weeks followed by six cycles of AVD.
Responding patients additionally received four brentuximab vedotin cycles as consolidation, after which the overall response and complete remission rates were 95% and 93%, respectively.
The antibody–drug conjugate brentuximab vedotin has also shown promise in children and young adults with primary refractory or early relapsed HL, according to phase I/II trial results published in The Lancet Oncology.
When given at the 1.8 mg/kg dose alongside gemcitabine, 57% of 42 evaluable participants aged less than 30 years had a complete response after four cycles of treatment, while 17% had a partial response, giving an overall response rate of 74%.
In light of the high activity and “tolerable” safety profile, Peter Cole, from the Rutgers Cancer Institute of New Jersey, and co-investigators, conclude that this combination “could be considered a viable first-line salvage regimen” for these patients.
In a phase I/IIa trial of patients with smoldering MM at moderate or high risk for progression to symptomatic disease, the multipeptide vaccine PVX-410 – either given alone or alongside lenalidomide – was shown to be well tolerated.
The majority of adverse events were mild or moderate among the 12 patients who received six doses of PVX-410 monotherapy at 0.4 or 0.8 mg every 2 weeks and the 10 patients who additionally received lenalidomide alongside the 0.8 mg dose.
Noopur Raje (Massachusetts General Hospital Cancer Center, Boston, USA) and colleagues say in JAMA Oncology that the clinical responses were “modest” as expected with the relatively short courses of therapy, but they believe that the vaccine merits further study.
The results of the 4-year follow-up of the phase III ELOQUENT-2 trial comprising patients with relapsed or refractory MM show that the progression-free survival benefit afforded by the addition of elotuzumab to lenalidomide and dexamethasone is maintained in the long term.
The risk for progression or death was a significant 29% lower among patients who received elotuzumab, which was “consistent with [the] 2- (30%) and 3-year follow-up data (27%),” report Meletios Dimopoulos (National and Kapodistrian University of Athens, Greece) and co-authors.
They conclude in Cancer that the sustained efficacy, together with “the well-established long-term safety and tolerability profile, supports this regimen as a valuable treatment option offering long-term benefits” to this patient population.
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